Responsible for developing, implementing, and managing a portfolio of Medicare products/programs. Develops and manages competitive offerings by overseeing market research and regulatory requirements, defining product requirements/features, designing the overall customer experience, and managing the product performance life cycle to support growth and retention. Identifies

The Lead HR Advisor Employee Relations serves as a trusted advisor to leaders across the organization and leads the deployment of key HR initiatives. This role will lead Medica's most complex and/or high risk employee investigations, consult and provide recommendations on organizational restructures and reductions in force, and provide enterprise wide support of both stra

The Senior Financial Analyst will prepare financial and regulatory reporting. The Senior Financial Analyst will be responsible for the annual regulatory reporting and lead regulatory audits in relation to the reporting. The role will improve financial status by analyzing results; monitoring variances; identifying trends; recommending actions to management. This position w

The Lead ETL Engineer is responsible for developing and maintaining applications using a variety of technologies like Informatica, shell scripting, SQL and ETL to support multiple lines of Business and IT initiatives. This position is responsible for technical analysis, design, development, testing, and deployment of IT solutions / Data warehouse solutions to support Medi

The Internal Auditor Advanced Staff will plan and conduct audit procedures, including identifying and defining issues, developing audit criteria, reviewing and analyzing evidence, and documenting the Internal Control over Financial Reporting (ICFR) and operating procedures of the organization. This position will prepare reports on findings and recommend improvements in po

Lean Six Sigma Black Belt Manager collaborates closely with cross functional leaders, vendors and employees at all levels. We have adopted a holistic approach to Lean Six Sigma where we identify Process Owners for ongoing continuous improvement in 7 key Value Streams. Each Value Stream is supported by a Black and Green Belt that evaluates, documents, designs, manage and m

Responsible for provider network strategy/design for all products and networks. Ensures Medica's provider networks meets federal, state and private adequacy measures by completing analysis, identifying gaps, researching and recommending solutions for provider network optimization. Partner with product and legal for regulatory review, submission of data filings and approva

Medica is currently seeking an experienced Manager, HRIS & Payroll to join our team. The Manager, HRIS & Payroll oversees the day to day Payroll and HRIS operations of a complex, multi state organization. This Manager will drive planning and execution of new HR systems, system configuration changes, and system upgrades. In addition, our Manager will oversee Medica's payro

Medica's Utilization Review Nurses are responsible for reviewing and documenting prior authorization requests and member case history in compliance with policies and procedures for approval of member coverage. This role will involve general medical reviews. These comprehensive reviews may include, however are not limited to surgical procedures, genetic testing, and care a

Medica Care Coordinators work independently to manage a specified case load of members and are responsible for creating an appropriate individualized care plan and coordinating the delivery of the approved medical and social services We provide education surrounding benefits including Medicare and Medicaid and serve as a trusted and primary contact for our members to addr

Develop and implement a strategic leadership development plan aligned with organizational goals and objectives Design and deliver leadership development programs, workshops, and initiatives to enhance leadership skills and capabilities at all levels Develop and implement comprehensive employee engagement strategies aligned with the organization's goals and values Collabor

This role will partner with senior level client services managers assigned to the company's largest strategic accounts. The role will work with directly with internal and external partners including consultants, organizational leadership on projects as required by contractual requirements, vendor needs and changes in federal and state laws. The role will serve as back up

Responsible for developing, implementing and managing a portfolio of products/programs. Develops and manages competitive offerings by overseeing market research and regulatory requirements, defining product requirements/features, designing the overall customer experience and managing the product performance life cycle. May have interaction with regulatory bodies. Key Acco

The Account Manager is responsible for building relationships with new clients while maintaining existing client base, coaching clients on all aspects of Medica's programs/products and client implementation. This role will also be responsible for the effective and timely resolution of service issues. The Account Manager will work with both self funded and fully insured cl

Strategic Account Executive's primary responsibility includes strategic management of a robust prospect pipeline along with building and maintaining key broker/agency relationships in the Prevea 360 service area. Responsible for the sale and implementation/onboarding of new groups. Career level position. Considered highly skilled at sales techniques and demonstrates stron